Cancer of the corpus uteri: initial symptoms, at what age, treatments and risks

This disease is easily diagnosed in early stages, because it gives symptoms from the earliest stages

Roberto De Filippis

March 06

When dealing with the topic of uterine tumorsfirst of all, it is important to distinguish those of the neck (cervix) and those of the body (endometrium). It is the second most widespread in Western countries: according to data from Airtum (Italian Association of Cancer Registries), in 2022 there were more than ten thousand new cases in Italy. Unlike cervical cancer, endometrial cancer tends to occur in old age and, in any case, after menopause, while in women under 40 it is extremely rare.

CANCER OF THE BODY OF THE UTERUS: THE ROLE OF ESTROGEN

The main cause of development of the tumor of the corpus uteri is represented by thehyperestrogenism, i.e. from an excessive activity of estrogen hormones not sufficiently balanced by progesterone, a hormone with an action opposite to that of estrogen. The more this balance is in favor of estrogen over the course of life, the more the chances of developing endometrial cancer increase. Therefore, those who have had early puberty, those who have entered menopause late and those who have not had pregnancies run a higher than average risk. This disease is also favored byobesityfromhypertension and from diabetes, while the use of the contraceptive pill, which has a balanced dosage of estrogens and progestogens, constitutes a sort of “protection”. “With many extra kilos, hypertension and late menopause: this is the typical profile of the patient with cancer of the corpus uteri” clarifies Dr. Giorgia Mangilihead of the Medical Oncological Gynecology Unit of the Irccs San Raffaele Hospital in Milan.

BEWARE OF BLOOD LOSS

Unlike most neoplasms, cancer of the corpus uteri manifests itself from the very early stages. This is testified by the fact that in over 80% of cases the disease is confined to the endometrium at the time of diagnosis. The characteristic symptom of this neoplasm is abnormal vaginal bleeding and, as it almost always occurs after menopause, this should alert you. “Since the tumor of the uterine body has a very evident manifestation, when traces are noticed on the panties that could suggest blood loss, one should not hesitate to consult a gynecologist” recommends Dr. Mangili. In the presence of suspicions, the first assessment to which one undergoes is a transvaginal ultrasound. If from this examination it emerges that the endometrial line is altered then we proceed tohysteroscopy which, in addition to making the body cavity of the uterus look good, also allows the execution of a targeted biopsy.

BODY CANCER OF THE UTERUS: MANY NEWS IN TREATMENTS

In order to follow the “evolution” that the disease is having over the years, the criteria that lead to the identification of the risk class of uterine cancer are also changing and, consequently, the criteria for choosing the best therapies in based on the individual patient. In most cases the treatment chosen in the presence of this neoplasm is represented by surgery: one proceeds with an intervention of hysterectomy, which consists in the removal of the entire uterus and which can also be performed with a minimally invasive technique, which involves laparoscopic access, through small incisions on the abdomen. Depending on the characteristics of the tumor, it may also be necessary to remove the tissue around the uterus, the ovary and part of the vagina. Depending on the involvement of the sentinel lymph nodes, the subsequent treatment pathways are then defined, which may consist of cycles of chemotherapy or radiation therapy or in simple checks. “There are many therapeutic innovations in this area and there are also many that could be available in the short term. For example, already today for some patients who are victims of recurrences theimmunotherapy” continues Dr. Mangili. One year after diagnosis, the probability of surviving over four years from cancer of the corpus uteri is 86%.



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